Virginal hypertrophy, also known as Müllerian agenesis or Mayer-Rokitansky-Küster-Hauser syndrome (MRKH), is a congenital condition that affects the development of the female reproductive tract, specifically the uterus and vagina. This rare condition occurs in approximately 1 in every 4,500 newborn girls. It is characterized the absence or underdevelopment of the uterus and upper two-thirds of the vagina, while the external genitalia appear normal.
The exact cause of virginal hypertrophy is not yet known, but it is believed to result from a combination of genetic and environmental factors. It is thought to be related to abnormalities in the development of the Müllerian ducts during embryogenesis. The Müllerian ducts are two structures that give rise to the female reproductive organs, including the uterus, fallopian tubes, and upper vagina. In individuals with virginal hypertrophy, these ducts fail to develop properly, leading to the absence or underdevelopment of the uterus and upper vagina.
The diagnosis of virginal hypertrophy is usually made during the teenage years, when a girl does not menstruate despite normal development of secondary sexual characteristics, such as breast development and the presence of pubic hair. The absence or underdevelopment of the uterus and vagina can be confirmed through a pelvic examination, ultrasound, or magnetic resonance imaging (MRI). Additional tests, such as karyotyping, may be performed to rule out associated chromosomal abnormalities.
While virginal hypertrophy does not affect a woman’s ability to have sexual intercourse, it can cause emotional distress and feelings of inadequacy due to the perceived difference from societal norms. Fortunately, there are treatment options available to address the physical and psychological aspects of the condition.
One of the main goals of treatment is to create a neovagina, a surgically constructed vagina, that allows for normal sexual intercourse and menstruation if desired. There are different surgical techniques available, including the Vecchietti procedure and the creation of a neovagina using local or distant tissue flaps. These surgical procedures aim to create a functional neovagina stretching the existing tissue or utilizing tissue from other parts of the body.
Neovaginal dilation is another non-surgical option that involves the use of graduated dilators to gradually stretch and expand the existing vaginal canal. This technique, conducted under the guidance of a healthcare professional, helps maintain the length and width of the neovagina after surgical intervention. It is important to note that both surgical and non-surgical options should be discussed with a gynecologist or a healthcare professional specialized in the treatment of virginal hypertrophy to determine the most suitable approach based on individual circumstances.
In addition to addressing the physical aspect of the condition, the emotional well-being of individuals with virginal hypertrophy should also be considered. Psychological support and counseling are crucial in helping patients cope with the diagnosis, manage any feelings of distress, and develop a positive body image. Support groups and online communities can also provide a valuable source of emotional support, connecting individuals with others who have experienced similar challenges.
It is important to highlight that virginal hypertrophy does not affect fertility. Women with this condition have normally functioning ovaries and can opt for other fertility treatments, such as in vitro fertilization (IVF) or surrogacy, if they desire to have biological children.
Virginal hypertrophy is a rare congenital condition characterized the absence or underdevelopment of the uterus and upper vagina. It can have a significant impact on the physical and emotional well-being of individuals affected. However, with advancements in surgical techniques and psychological support, women with virginal hypertrophy can lead fulfilling lives and have the option to undergo procedures to create a neovagina and pursue fertility treatments if desired. It is important for individuals with this condition to seek appropriate medical care and support to address both the physical and psychological aspects of their condition.